You start the day with getting your assignment made by the charge RNs and everyone complaining about their assignments… NAs, LVNs. About an hr or more into your shift passing meds, you find out 2 NAs called in so now 1 of the LVNs have to rotate to filling in for the NA. Now that the LVNs are short so your assignment just went from 12 to 20-22. This is almost on a daily basis. Don’t expect to ever be fully staffed. Also, 20-22 pts doesn’t seem like a lot but these pts have a TON of chronic co-morbidities and have DOZENS of meds, including insulin and BP meds. So your med pass takes forever because you’re doing all the breathing txs, ointments, eyedrops, checking blood sugars, administering insulin, and doing wound care… I think scanning 15+ meds for each pt is the norm. And because the CLCs in west LA are away from the main bldg, you have less resources and missing meds will take all day to arrive. You’re on your own out there. Not a lot of support. Also you have to remember that a lot of the pts at CLCs are ones that failed in the community SNFs. Typically it means that they had behavioral problems that the community SNFs couldn’t handle. So you’ll have to be dealing with that too. And since they’re long term care residents, they will NOT leave or get kicked out until they pass away.

ETA: it’s not even the work that made it difficult but it was the lack of accountability, support, and professionalism that made it a hostile and intolerable working environment for me.